Eastman Dental Hospital
Dental implants general information for patients
Department of Restorative Dentistry
First published:
January 2004
Last review date:
March 2014
Next review date:
March 2016
Leaflet code:
UCLH/SH/EDH/RESTDENT/IMPLANT/2
© University College London Hospitals NHS Foundation Trust
Created by Medical Illustration RNTNEH 020 3456 5103 Unique Code: 29360
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Contact
Eastman Dental Hospital
Department of Restorative Dentistry
Telephone:
020 3456 7899
Opening hours :
08:30 to 17:30
Monday to Friday
Address:
The Eastman Dental Hospital
256 Gray’s Inn Road
London WC1X 8LD
Website:
www.uclh.nhs.uk
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How do I know if implants are for me?
Your suitability for implant treatment is assessed initially at your first
consultation. At this time your consultant will also discuss with you
your eligibility for NHS implant treatment. If you are suitable for
implants but are not eligible for NHS implant treatment, you will be
advised to consider this treatment as wholly private treatment,
normally through your own dentist. Private implant treatment is
available through the Eastman’s Private Patients’ Unit. If you wish to
pursue this option then you will need to contact the Unit directly or
your dentist can refer you .
What will happen if I choose not to have implants?
If you decide not to have implants, then you may consider the
alternative forms of treatment for tooth replacement. These will
include dentures or bridges or accepting the gaps. The
consequences of not having the teeth replaced will also be explained
to you.
Where can I get more information?
You can get further information about implants from:
If you need a large print, audio or translated copy of this
document, please contact us on 020 3456 2378. We will try our
best to meet your needs.
Contents
What is a dental implant?
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What are the benefits/advantages of dental implants?
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Are dental implants safe?
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Are implants suitable for everyone?
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What if I do not have enough bone?
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How successful are dental implants?
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What types of implants are available?
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How do dental implants work?
9
How will I feel after the surgery?
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Can I wear my teeth after the implant surgery?
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Will I need additional investigations?
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The Association of Dental Implantology
What happens after the implant treatment is completed?
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Address:
Implant Co-ordinator,
Room N21,
2nd Floor,
New Wing
Can anything go wrong?
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What do implants cost?
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How do I know if implants are for me?
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www.adi.org
What will happen if I choose not to have implants?
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Where can I get more information?
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Contact
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Website:
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After Surgery:
• Failure of the implant to integrate into the jaw bone: Occasionally
the implant fails to unite with the jaw bone and has to be removed.
Depending on the reason for the failure, it may be possible to
replace the implant after a healing period.
• Infection: This is a rare complication which can occur. Usually
antibiotics will be prescribed and the site of the infection monitored.
Long Term:
• Wear or breakage of the implant retained prosthesis: Crowns,
bridges or dentures may need refurbishment with time due to wear.
This refurbishment will incur an additional cost. Teeth may also
break if you are using them inappropriately. Additionally the clips or
screws retaining your false teeth (dentures) to the implant may
break or wear out with use and may require replacement.
• Poor cleaning around the implants can cause infection and loss of
the implant (metal root). This inflammation is called mucositis or
peri-implantitis if you have also lost bone around the implant.
What do implants cost?
The cost of dental implants is expensive due to the material from
which they are made. The cost of the treatment is dependent on a
number of factors, including the number you need and the type of
treatment you have.
Dentures (you remove these for cleaning) retained on implants are
less costly than a fixed bridge (this is fixed in your mouth). NHS
funding for dental implants is limited and strict criteria have to be met
for acceptance onto this scheme.
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What happens after the implant treatment is
completed?
Once your treatment is complete, your implants need regular care to
ensure they are functioning well. Your ability to clean around your
implants is critical to ensure long term success.
If you do not keep your implants clean, your gums may swell and
bleed, cause infection of the bone and result in you losing your
implant. Smoking can also cause your implants to fail. As with crowns
and bridges, the teeth on your implants will wear and may need
replacement.
Can anything go wrong?
Complications may occur at different times during your treatment.
During Surgery:
• Occasionally, it may not be possible to place the implants due to
unforeseen problems. If this occurs, you will be informed. In these
situations you may have to opt for the conventional methods of
replacing your missing teeth.
• Numbness of the surrounding area: Depending on where your
implants are placed, occasionally you may suffer numbness of the
surrounding area after the surgery. This usually resolves over time.
However in a few cases you may suffer permanent numbness.
• Bone grafting: Complications with bone grafting will be discussed
with you prior to your surgery. In some patients, especially
smokers, the bone graft may not take. If this occurs conventional
forms of treatment may need to be considered.
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A missing tooth or missing teeth can be distressing
and result in loss of confidence. Dental implants can
be used to help replace missing teeth.
This leaflet explains dental implants and gives an overview of the
different options. It also covers their potential risks and benefits. After
reading the leaflet, if you have any questions you should contact your
dentist or your specialist.
What is a dental implant?
A dental implant is a tooth root made from titanium and shaped like a
screw. It is placed into the jaw bone. The implant is used as an
anchor to support the artificial tooth.
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What are the benefits/advantages of dental implants?
Will I need additional investigations?
Dental implants offer you the possibility of having false teeth, which
can feel similar to your own. Implants can be used to replace missing
teeth without the need to drill into the adjacent teeth. They also help
preserve the jaw bone.
Usually assessment is undertaken using standard X-rays. However
sometimes further investigations may be needed to assist with
planning. These are the use of special X-rays called tomograms (a)
which show the width of bone. Sometimes CT scans are also used to
show the bone anatomy in three dimensions (b). In addition to these
you may need to have moulds of your teeth taken to set up the
intended position of the teeth called a ‘diagnostic wax-up’ (c).
Dental implants can be used for a number of situations and needs,
including replacement of a single tooth, several teeth or to support a
loose denture when all teeth are missing. Although they replace
missing teeth they do not necessarily enhance appearance.
Are dental implants safe?
Titanium, the material from which implants are made, is accepted by
the tissues of the body, and hence is safe to use. Almost all dental
implants in use today are made from titanium or titanium alloy to
enable the implants to bond to the bone. The terms ‘endosseous
implants’ or ‘osseointegrated implants’ are used to describe the
implants in use today and indicate the close union of the implant to
the bone. There are many dental implant systems available, and if
used correctly all can deliver a reliable form of treatment.
Although implants are safe to use, individuals vary in their response to
treatment due to differences in the way they heal. This occasionally
may cause problems and also contribute to the failure of implants.
a
b
Implant
supported
denture
c
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take from three to six months. This time is increased to eight to nine
months if a bone graft is needed. During the time the implants are
bonding to the bone you may have to go without teeth for a few days.
If you have had a two stage implant you may have to undergo
another minor surgical procedure before the restorative phase of
treatment starts. After this the second restorative phase starts. This
involves taking a mould of the implant onto which the false tooth is
anchored. The false tooth is usually made by a dental technician
from this mould. Depending on whether you are having a denture
retained on implants, a bridge, or a crown, the restorative procedure
will vary and this will also determine the treatment time. The total
treatment time is normally one year from start to finish.
How will I feel after the surgery?
Following surgery you will experience some swelling and discomfort
during the first few days. You may also experience some slight
discomfort and pain in the immediate healing period. Painkillers can be
used to help ease this discomfort. You will need to be seen one week
after the surgery to have your stitches removed. Your clinician will
check your mouth and dress your temporary teeth. You will be kept
under review until the second part of the treatment takes place.
Can I wear my teeth after the implant surgery?
Immediately after the surgery, you will not be able to wear your teeth
for a few days. After this if you wear a denture, this will be adjusted
and relined. If you wear a bridge this will need to be fitted.
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Are implants suitable for everyone?
You need to be relatively fit and healthy, and the overall care of your
mouth also has to be good. If you cannot tolerate having surgery,
implants are not suitable for you. You also need to have enough jaw
bone height and volume. If you have inadequate bone volume, it is
possible to build it up with a graft, which may be your own bone or an
artificial bone substitute. Your suitability for implant treatment and the
need for grafting will be decided and discussed with you by your
clinician.
What if I do not have enough bone?
Bone can be grafted if you do not have enough bone to place the implant
into your jaw bone. Grafting can be done to create the bone width
needed to place the implants. In cases like this, it is common for the graft
to be taken from another site either inside the mouth or from a site such
as the hip. The graft would then be allowed to heal for a period of 6
months before you are reassessed for the implant placement. If
however, there is enough bone to place the implant, but there is a risk of
some exposure of the implant, then grafting can be undertaken at the
same time as the implant placement. It is normal practice to use your
own bone for the grafting. However, sometimes due to the limited
amount of bone that can be collected, alternative grafting materials may
be used. These can be of animal origin (normally cow bone) or can be
synthetic. These grafts if used would normally need protecting with a
barrier membrane which is often made of collagen derived from animal
sources. If you need to have bone grafting, then the treatment time will
be prolonged by at least four months. Your clinician will discuss the
alternative ways of rebuilding your own bone with you following your
initial assessment.
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How successful are dental implants?
Today implants have a high success rate 80 to 95% over 15 years - in patients with healthy mouths. The
success rates for dental implants in patients who are susceptible to
gum disease is slightly lower - 80 to 85% over seven years. Over 90%
of implants bond successfully to the jaw bone.
a
b
c
Certain factors such as the quality of your jaw bone, unstable gum
disease and smoking reduce the predictability and outcome of implant
treatment.
Smokers have a higher failure rate and we expect you stop smoking at
least six months prior to starting implant treatment. Patients who have a
habit of grinding their teeth are also at a risk of overloading their
implants. This can reduce the success rate of the implants. Once
implants have healed into your jaw bone, the long term success rates
are also dependent on your ability to maintain and keep your implants
clean and having them checked regularly.
d
e
Two Stage Procedure showing implant placed and covered over
(a, b); X-ray showing implant (c) and second stage surgery
uncovering the implant (d, e)
What types of implants are available?
There are a number of different implants available. The differences are
mainly in the implant surface and the shape. Implants are also
available to be used as a one stage or a two stage procedure. In the
former, you undergo one surgical procedure to place the implants and
you will be able to see a little bit of the metal covering the implant head
in your mouth. In the second you have to have two surgical
procedures, one to place the implant into the jaw bone (the gum is
replaced over the implant) and a second minor procedure to uncover
the implant and connect it to the mouth. This is sometimes referred to
as a submerged implant. After examining you carefully, your clinician
will decide which procedure is going to be suitable for you.
a
b
One Stage Procedure showing implant placed and left
connected to the mouth
How do dental implants work?
Implant treatment involves two phases, the surgical phase and the
restorative phase. The first part (surgical phase) involves placing the
implant (metal root) into the jaw bone. The surgery is normally carried
out under local anaesthesia as an outpatient and is generally not
painful. The implant is then allowed to bond to the bone, which can